膀胱癌术前活检较术后病理分级低估的临床分析

目的:研究膀胱癌术前活检较术后病理分级低估可能的原因. 方法: 总结75例术前膀胱镜活检诊断膀胱癌,术后病理检查资料完整的患者分级进行比较分析. 结果: 75例患者术前活检病理分级G1 22例,G2 49例,G3 4例;术后标本病理分级为G1 2例,G2 26例,G3 47例;术前活检病理分级与术后标本病理分级一致22例(29.33%),活检低估分级50例 (66.67%),高估分级3例(4.00%), 三组比较存在显著性差异(P＜0.01).结论: 膀胱癌的术前活检与术后病理分级比较存在低估现象,充分重视低估现象可避免治疗不足的发生.     

膀胱癌术前活检较术后病理分级低估的临床分析

目的：研究膀胱癌术前活检较术后病理分级低估可能的原因。方法：总结75例术前膀胱镜活检诊断膀胱癌,术后病理检查资料完整的患者分级进行比较分析。结果：75例患者术前活检病理分级G1 22例,G2 49例,G3 4例;术后标本病理分级为G1 2例,G2 26例,G3 47例;术前活检病理分级与术后标本病理分级一致22例（29．33％）,活检低估分级50例（66.67％）,高估分级3例（4．00％）,三组比较存在显著性差异（P〈0．01）。结论：膀胱癌的术前活检与术后病理分级比较存在低估现象,充分重视低估现象可避免治疗不足的发生。     

Structure of the MAST with an Australian sample of alcoholics

The dimensionality of the Michigan Alcoholism Screening Test (MAST) was examined utilizing an Australian sample (n = 196) of alcoholics. This study was specifically designed to overcome some of the problems with sampling and analytic techniques used in previous studies. Three moderately intercorrelated factors were revealed which covered (a) alcohol-related disabilities; (b) help-seeking behaviour and (c) recognition of a drinking problem. These factors were found to be internally consistent as shown by moderate to high alpha coefficients. Results indicate that the additive system of scoring all 24 items may result in an underestimation of the information afforded by the MAST.     

The Finding of Invasive Cancer After a Preoperative Diagnosis of Ductal Carcinoma-In-Situ: Causes of Ductal Carcinoma-In-Situ Underestimates With Stereotactic 14-Gauge Needle Biopsy

Background: For the evaluation of nonpalpable lesions of the breast, image-guided 14-gauge automated needle biopsy is increasingly replacing wire-localized excision. When ductal carcinoma-in-situ (DCIS) is diagnosed at core biopsy, invasive cancer is found in approximately 17% of excision specimens. These so-called DCIS underestimates pose a problem for patients and surgeons, because they generally cause extension of treatment. We evaluated DCIS underestimates in detail to assess reasons for missing the invasive component at core biopsy. This evaluation also included a histological comparison with true DCIS (DCIS at core biopsy and excision).Methods: Between 1997 and 2000, DCIS was diagnosed at 14-gauge needle biopsy in 255 patients. In 41 cases (16%), invasive cancer was found at excision. We performed a thorough histopathological and radiological review of all these DCIS underestimates, including a histological comparison with core biopsy specimens of 32 true DCIS cases. We assessed the main reason for missing the invasive component at core biopsy.Results: Causes for DCIS underestimates were categorized into mainly radiological (n = 20), mainly histopathological (n = 15), and histological disagreements (n = 6). High-grade DCIS and periductal inflammation in core biopsies made a DCIS underestimate 2.9 and 3.3 times more likely, respectively.Conclusions: A variety of radiological and histopathological reasons contribute to the DCIS underestimate rate. Approximately half of these are potentially avoidable.